JGH OPEN: 给食管静脉曲张患者放置肠管出现消化道出血的风险因素

2020-04-12 MedSci原创 MedSci原创

食管静脉曲张(EV)患者由于易引发静脉曲张破裂出血,因此应谨慎置入肠管(ET)进行胃肠减压或相关治疗。目前患有EV的患者胃肠道出血(GIB)发生率和预测因素数据有限。

背景与目标:食管静脉曲张(EV)患者由于易引发静脉曲张破裂出血,因此应谨慎置入肠管(ET)进行胃肠减压或相关治疗。目前患有EV的患者胃肠道出血(GIB)发生率和预测因素数据有限。本研究旨在评估ET植入后EV患者出血的发生率和预测因素。

方法:研究人员对需要进行ET的EV患者进行了回顾性研究。纳入标准为年龄>18岁且经内镜证实的EV且需要放置ET的患者,并排除了在放置ET之前接受GIB或发生GIB的患者,以及接受肝移植的患者。主要观察结果是在放置管后48小时内发生GIB的发生率。次要观察结果是放置48小时内血红蛋白下降>2g/dL,无出血迹象。使用Fischer精确检验,Mann-Whitney U检验和单变量logistic回归模型进行统计分析。

结果:本项研究共包括75位患者。肝硬化的最常见病因是饮酒(44%)。EV最常见的位置是食道的下三分之一(61%)。在11名(14.6%)患者中观察到了主要结局。在八名(10.6%)患者中发现了次要结果。单因素分析显示,GIB与食管下端三分之一的较高的MELD-Na(P=0.026)和EV相关(P=0.048)。

结论:EV患者的ET放置与出血风险低相关。升高的MELD-Na和较低的EV位置会导致放置ET后出血的风险更高。

原始出处:

Lolwa N Al‐Obaid. Et al. Enteric tube placement in patients with esophageal varices: Risks and predictors of postinsertion gastrointestinal bleeding. journal of gastroenterology and hepatology.2020.

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    2021-03-27 fusion
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    2020-04-18 feather89
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    2020-04-14 zhouqu_8
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